Needless to say most of the umbrage is coming from the Right. They might as well be saying ‘Gordon Brown can pry my liver from my cold dead hand’ for all the sense they’re making. They bang on about the ‘murder’ of foetuses by the ‘abortion industry’ but are seemingly willing to stand by and let walking, talking people die because their politics have been offended.

What it boils down to is putting your principles before the lives of dying people. And what’s more, you’ll be dead anyway and won’t even get to enjoy the smug satisfaction of putting one over on Gordon Brown with your clever principles. Because you’ll be dead (did I mention that?).

Unless you believe in heaven, obviously, in which case I suppose you could look down and blow raspberries in Gordon’s direction. If they let, smug, selfish, gloating pricks into heaven, that is. And unless you’re expecting an Assumption, you can’t take your guts to heaven either.It seems that these people would rather take their organs with them to the grave or the crematorium out of some kind of spite. Even more amusingly, others are signed up to voluntarily donate their organs and they’re still complaining. They’re giving their organs when they die but they’re still all ‘Wah! The state wants to own my body! Wah!’

You could sort of see these people’s points of view if there was an alternative use to which you could put a human corpse. I suppose some of the egos we’re talking about would quite fancy being stuffed and put in a museum but they have to take your guts out to do that anyway.

Anybody planning to have their sweetbreads turned into pate to sell for the benefit of their dependents? No, you’re going to have them burned or buried with you unless Gordon Brown extends a bloody claw and tears them from your still warm corpse.

I think this stems from a certain attitude. Namely that mature strand of reasoning that non-ironically equates the state with fascism. You see it a lot on the less fun blogs. Sure, it might be a good idea and think of the lives that will be saved, they seem to be saying, but it’s Gordon bloody Brown’s idea so it must be shit, the one-eyed mental nazi.

‘It strikes at our relationship with the state,’ they say. Well get this: You can’t have a relationship with the state when you’re dead. You can’t assert ownership over your own corpse. Why? Because. You. Are. Dead. What other freedoms would you like to exercise after you’ve shuffled off? I take it you’ll be putting your favourite songs on your iPod to take with you as well? It’ll be as much use to you as your liver.

Do you really not have anything else to worry about? I’m more worried about the horrifying, demeaning death I’m likely to suffer at the hands of the NHS than what they might do to my corpse once I’ve screamed my last.

This state-as-bodysnatcher pose is perverse in the extreme and reflective of the implicit (rapidly becoming explicit) immaturity that’s taking this country back to the Middle Ages at a dizzying speed. Maybe these people just haven’t been shown enough footage of cute ickle children dying for lack of available organs. With a Snow Patrol song played over the top. That should sway them, surely?

Reader comments

“Even more amusingly, others are signed up to voluntarily donate their organs and they’re still complaining. They’re giving their organs when they die but they’re still all ‘Wah! The state wants to own my body! Wah!’”

I see, so these people are supposedly simultaneously selfish, putting principle before the lives of others, but also are on the voluntary on the organ donor register to save those same lives. In other words, they hold to a principle of saving lives. They would just rather give consent before they have their body sliced up.

If there was a free (or even limited) market in organs after death, then I am fairly sure next of kin would be much more willing to donate organs too. Shouldn’t the liberal left endorse the less coercive and more effective option?

Shouldn’t the liberal left endorse the less coercive and more effective option?

But Justin’s basic point still stands – why does the right suddenly find choice abhorrent when it comes to abortion… but in this case can’t stop falling over themselves to display their libertarian credentials?

This is my fundamental point of disagreement with you. I very much think that one does get to determine what happens to one’s corpse after death. We get to determine the manner of our funeral, whether we’re buried or cremated or mounted or whatever. This seems fair to me. Moreover, I would say that I don’t think that our families have any more rights to determine what happens to our corpse than the NHS does. If someone dies holding an organ donor card then I don’t believe the family should have the right to overrule that.

I’d like to see donation rates increase, but I don’t think this is the way to do it. The end doesn’t justify the means. Continually stressing the importance of opting in, and encouraging more people to do so, and removing any right for this opt in to be vetoed by others is what I would like to see.

One final point I would make is that I don’t think taking such an aggressive, mocking approach to those who are uneasy about an opt-out system will do anything to persuade them to come over to your side. If we do move to an opt-out system, then I think seeking to stigmatise those who do opt out must be avoided.

“I very much think that one does get to determine what happens to one’s corpse after death. We get to determine the manner of our funeral, whether we’re buried or cremated or mounted or whatever. This seems fair to me. Moreover, I would say that I don’t think that our families have any more rights to determine what happens to our corpse than the NHS does. If someone dies holding an organ donor card then I don’t believe the family should have the right to overrule that.”

So what’s the problem with opting out if you’ve got enough of a forethought to plan the extravagances of your own body after it has ceased to be alive? A lot of the people arguing against this opt in are saying that it is an affront to their rights. It is not, simply because your right to not be harvested still exists, and that will likely happen more often than it should if a “soft” approach is taken that allows families to rule out organ donation still.

Their next issue seems to be with the lack of choice (again, see above), and in reply to 1. I’d say that people stating on blogs that they are voluntary donors but will take themselves off of the register and opt out if this becomes law just goes to show the mentality of the people. They’re happy to donate organs if they can slip it in to conversation that they’re a kind soul that will donate to save lives when they die, but if it’s state mandated it then the glory from that has gone and thus no-one can have your glorious life saving pieces of meat.

Ultimately we already assume a lot about how we can treat dying people and dead people. The procedures performed on dead people who’ve died mysteriously, do we ever sign forms to say we’re ok with people slicing us up and inspecting our “temple” if we’ve died mysteriously? No we take it as a given that this is a good practice to either bring about justice or to help stop the thing that killed us killing more people. We receive blood transfusions unless we distinctly are noted as not wanting them, we are automatically resuscitated unless there is a living will (or whatever it is officially called) around. It really stinks for people to be kicking up a fuss about this issue when they are quite happy not to spend time agreeing and signing that they want all of the above.

But you’re absolutely spot on about your stigmatisation stance. Unfortunately some on the more left side of the political spectrum are saying they’d rather see no opt-out and that everyone has to comply. This would be unacceptable and really muddies the debate. Everyone has a right to do what they want with their body, and with 90% of people stating that they wouldn’t mind giving their organs when they die it is really much much more efficient to let the 10% opt-out and advertise that clearly when people get things such as driving licenses, passports and register with GP’s rather than try and persuade another (I believe) 70% to sign up.

“why does the right suddenly find choice abhorrent when it comes to abortion”

Well libertarians hold to a right to life, liberty and (justly acquired) property – life being first and foremost. (I don’t know what values conservatives hold to exactly, they just seem to agree with libertarians about 2/3rds of the time, at least when they are in opposition).

But it is (just about) consistent to be a libertarian and a hardliner on abortion, so long as you hold to a certain view of what life is and when it begins (one that I don’t happen to hold to). Since abortion involves actively killing a human (on that particular view), it is a bit different from simply not giving someone an organ. It is the difference between death and murder: you don’t have the right to not die (not that anything can stop that anyway), but you do have the right not to be murdered.

7. Is right, the belief of potentially ruining someone’s life because they can’t physically, emotionally, socially or economically handle having a child because of anti-abortion laws would be pretty damn compatible with the view of happily ruining someone’s chances at life because of a point of principle.

“But Justin’s basic point still stands – why does the right suddenly find choice abhorrent when it comes to abortion… but in this case can’t stop falling over themselves to display their libertarian credentials?”

Careful, that goes both ways. Why are we for choice over control of people’s bodies in one case and not in the other?

I found this article crass, annoying and a good example of the immaturity it claims to rail against. A good deal of people I’ve read having an objection to it are themselves on the donor list voluntarily. These aren’t people jealously guarding their valuable, decaying organs but people creeped out by the idea of the state claiming ownership of their bodies. What you could have done here is show that there is no less assertive way to drive up donor rates (which I don’t believe) and save these lives, instead you chose to mock people. Bravo.

I see, so we should kill people so long as it is for sound economic, social and emotional reasons? Well I suppose if the ends justify the means…

Any idea now, why libertarians and conservatives tend not to like moving an inch on things like organ donations? How long till individuals are told by the state to forego one eye or a kidney for sound economic, social or emotional reasons according to that logic?

10. Alas, the issues are so much more complicated than that when it comes to the net welfare of individuals involved in each situation and so such requests would never happen under such “logic”. That’s not to mention the further debate about “life” in terms of abortion.

Indeed it would seem that you value the lives of people known to be alive yet dying less than those that are not known to be “alive” at all, or do you accept that an opt-out system on organ donation will save more lives?

Even so, it is a very slippery slope when the state takes on itself the right to decide how I want to dispose of my body.

I made a comment here (almost as mad a thread as the above) on the issue of who owns your body

Why does your family have an automatically stronger claim than anybody else on your body post mortem?

Two points. First, if you don’t have any rules or laws on this, then your dead body can be homesteaded by whoever gets there first – not the sort of society I want to live (or die) in.

Second, even accepting Andrew’s point about families, not automatically being the best unit of society, if you have entered into a family relationship – whether gay, straight, polygamous or whatever, then you have passed the point of his argument. If you haven’t done that and you are truly alone, well quite frankly if that happened to me, you can stick a rocket up my arse and send me to Mars for all I care.

In the end surely we need to make organ donation more of a contractual relationship. I don’t agree with selling organs, I think that opens up too many of the problems highlighted by giving the state the power to harvest them. Surely all we need to say is, if you don’t join the club you can’t play. In other words if you haven’t agreed to donate your own organs, then you can’t have any from anyone else.

I don’t think this is a fundamental Libertarian issue. Your body is either useful or dust. It’s not property when you die, you’re dead, you don’t own shit.

Opting out should be easy and straight forward for those with religious issues. Accusing the government of body-harvesting is pretty lame. Many other nations have switched to a presumption policy. Word of advice to Tories: pick the fights worth fighting.

“Indeed it would seem that you value the lives of people known to be alive yet dying less than those that are not known to be “alive” at all, or do you accept that an opt-out system on organ donation will save more lives?”

I think a free market in organs (perhaps integrated into a health insurance scheme) would save many more lives. You would have very few opt outs at all (only the religious, really) if you gave people a rational reason to take part in an organ donor scheme.

BTW, I happen to be politically pro-choice on abortion (especially early term). All I am saying is that if you do accept the foetus is a human life (which I don’t), then legal abortion will appear highly anomalous and potentially dangerous in the precedents it sets, precisely because its leads to the sort calculus of deciding whether a person’s right not to be killed “costs” too much. I accept a woman’s right to choose because I fear the alternative would be the state.

Typical scaremongering that you link to. The doctor that works on you does so to save your life, and no doctor with any self-preservation in mind (or at least no fondness for being taken to court) would cut you off sooner than necessary. Then completely different individuals would be involved in your organs and where they go. To try and argue that doctors are part of some kind of pirate organisation that would willingly kill one man to save a couple more is quite honestly insulting to the profession and the reasons that such people do what they do.

Free markets are also a bad idea that advantage the well off more than the poor. Yes everyone would be donating, but who would be gaining the benefits? And where is the fairness in one persons life being valued so much less than someone else and vice versa? Even if there were enough organs to go around the problem would still not be alleviated. I could almost agree with tax benefits for families of the deceased (i.e. on inheritance tax) except that such moves also benefit richer families disproportionately while costing the state. Compensation would be fairer to all but potentially insulting and almost certainly costly.

And what I find most interesting is that you would much more believe in the innocence and good faith of those with ill relatives when potentially thousands of pounds are in it for them when they die in a free market on organs, but you would maybe opt out of any other system because of those crazy death dealing doctors!

“And what I find most interesting is that you would much more believe in the innocence and good faith of those with ill relatives when potentially thousands of pounds are in it for them when they die in a free market on organs, but you would maybe opt out of any other system because of those crazy death dealing doctors!”

Well if you are worried about grasping relatives, you can always bequeath your organs (or the value of them) to someone else. But not if the state owns them by default. But in general, I would rather rely on the good faith and innocence of families than public servants.

I personally think that freer markets will tend to produce the best results in the longterm (even for the poorest) due to the added spur to technological innovation (rodent organs are already being grown in research labs as we type – I heard on Radio 4 yesterday). But, if you have a problem with short term inequity based on market pricing, then you could have a more regulated market instead. Perhaps the NHS could be a monopsony buyer with a set national price list for useful organs paid upon death. The organs are then donated to whoever is next in line on the organ list. If it were still stricly voluntary (or “opt-in”), this would be a consensual exchange rather than simple compensation.

For those who don’t like their relatives, perhaps a small tax or national insurance credit could be arranged for those that sign a contract to donate organs after their death if they are in a suitable condition. I am not necessarily dramatically in favour of these state-organised incentive structures but they are still far preferable to the state just assuming ownership over people’s organs.

We get to determine the manner of our funeral, whether we’re buried or cremated or mounted or whatever.

Erm, we don’t, actually. You can express whatever preferences you like for the disposal of your body but there is no legal obligation on anyone to follow them. If you want grandad cremated, and you are the next of kin that is what will happen. Sorry grandpa!

May I also take this opportunity to publicly express my opposition to being mounted after death, under any circumstances, and especially by the government who have fucked me over quite enough already. Thank you.

“Well if you are worried about grasping relatives, you can always bequeath your organs (or the value of them) to someone else. But not if the state owns them by default.”

Yes you can, you can opt-out and *still* do so. If you want to do one what’s the problem in doing the other in the process? I have yet to hear any real argument as to why the opt-out system is really so reprehensible, especially if the task of opting out is a highly visible, easy and free process at appropriate times to choose.

I guess it shows the diversity of beliefs on what is moral. I find it somewhat disgusting to think that anyone would consider healthcare systems in this country that are driven by monetary profit for such outcomes (rather than giving compensation for the benefit that is provided through a presumed consent system), where as others like yourself, Nick, obviously find my belief that the most efficient way of serving public opinion should be used as procedure even if that means the burden of choice shifts to a different demographic as deeply abhorrent.

Another question, why is it that the current system should ask the 90% of people that agree with organ donation to donate when the alternative of asking 10% of the people that don’t to opt-out is blatantly an easier task? Is it really the best use of resources?

and especially by the government who have fucked me over quite enough already.

Wait until the Tories get into power…

I actually like this point made by Lee Griffin above:

Everyone has a right to do what they want with their body, and with 90% of people stating that they wouldn’t mind giving their organs when they die it is really much much more efficient to let the 10% opt-out and advertise that clearly when people get things such as driving licenses, passports and register with GP’s rather than try and persuade another (I believe) 70% to sign up.

Spot on.

Nick says:But it is (just about) consistent to be a libertarian and a hardliner on abortion, so long as you hold to a certain view of what life is and when it begins (one that I don’t happen to hold to). Since abortion involves actively killing a human (on that particular view), it is a bit different from simply not giving someone an organ.

I’m sorry but this doesn’t make sense to me. Frame the debate in a different way – do people have control over their own bodies or not? If framed that way – abortion is the exercise of choice over one’s own body, regardless of when others deem that a life has been born and is now protected by the state.

It seems you people are happy for the state to interfere in one instance and not another.

What he argued, amongst other things, was that the poor would benefit quite heavily because they could borrow capital against the value of their organs. (Or, of course, they could donate now: after all, a whole liver can grow quite well from a smallish piece.) People who could never raise capital now, could do so.

“… my belief that the most efficient way of serving public opinion should be used as procedure…”

What he argued, amongst other things, was that the poor would benefit quite heavily because they could borrow capital against the value of their organs.

Being able to borrow against a collateral that is potentially very high risk (if you business fails you lose your kidney) is hardly being put in an advantageous position. It is merely allowing people to commodify their own existence.

If framed that way – abortion is the exercise of choice over one’s own body, regardless of when others deem that a life has been born and is now protected by the state.

It’s a question, in that case of priorities (like Nick, I don’t subscribe to the following myself, but I understand why some people do).

As Nick says, libertarianism is founded on the right to life, liberty and (justly acquired) property. Now, most libertarians will argue that life is the most important of these (hence its positioning).

As such, many libertarians believe that the foetus’s right to life trumps that of the mother’s inconvenience (for want of a better word). Is the right of the foetus more important than the right of a woman to control her own body?

On one hand, you have nine months of inconvenience followed by pain in childbirth, or you have a life prematurely snuffed out. Of course, there are other factors to complicate matters – such as the chances that the mother will die if the pregnancy is continued – but that is the essence of the argument.

As such, many libertarians believe that the foetus’s right to life trumps that of the mother’s inconvenience (for want of a better word). Is the right of the foetus more important than the right of a woman to control her own body?

Framed that way, one could also argue that lives saved as a result of the increased organ donation trumps the (small minority) of people who don’t want to donate their organs when they die.

Most people are for this but never give explicit consent. So by doing an opt-out system, which doesn’t actually take away any freedom, more lives are saved through increased donation. Life trumps.

Being able to borrow against a collateral that is potentially very high risk (if you business fails you lose your kidney) is hardly being put in an advantageous position. It is merely allowing people to commodify their own existence.

Indeed so. But you would have it on a monthly repayment scheme: you’d be, effectively, mortgaging your organs. However, it would give people an added incentive not to screw up their bodies…

And if the public is overwhelmingly in favour of donating… . then?

Then it should go through; we do, after all, live in a democracy, of a kind.

A little anecdote. A few months ago, I was protesting in Bournemouth at the lack of a referendum on the Lisbon Treaty. One Labour delegate walked by and said that he was absolutely opposed to a referendum. So we asked him why.

“Because we live in a representative democracy,” was his reply.

But fundamentally, how do we know what we are voting for? Essentially, the manifestos of the parties are their representation. When I wrote about this incident, I pointed out that – if you believe that the Lisbon Treaty is the EU Constitution, of course – when Labour represented themselves to the electorate, they promised a referendum.

I believe that any non-administrative move, such as this change in organ donation, that is not in a manifesto – that is not in the goverment’s representation to us – that it should go to a referendum.

In any case, the sad thing about this is that I – and a number of other people have expressed this same view – am considering opting out whereas, up till now, I have always carried a donor card.

You may think that’s petty: perhaps it is – but I would rather opt out and then draw up a living will, for instance, that says, “in the event of my brain death, you can have my organs.”

Are you OK? I know asking the Devil himself whether his sanity is in any sort of order suggests that I’ve been possessed.

But a real devil would have come up with a far better arguement than the master of his domestic arrangements has achieved here.

The point of this thread was not you quoting life, liberty and property. Unless the madgod himself see’s corpses as his own, personal property. Perhaps he does. But, if the satan’s spawn sees a corpse that has not refused consent to it’s useful organs being used, then said devil is likely to find itself up against Papa Legba. Or Voodoo!

Framed that way, one could also argue that lives saved as a result of the increased organ donation trumps the (small minority) of people who don’t want to donate their organs when they die.

Ah, no; remember the other two pillars: liberty and justly acquired property. Just as the state cannot own you when you live, it cannot own you when you die. Second, your body is your justly acquired property.

The point that doesn’t seem to have been made explicit here (whilst it has been on blogs) is that you do own things when you are dead – or, rather, your estate does.

The idea of libertarianism is that no one may impinge on your rights; thus the state may not steal your body, dead or not. If you argue that it can, I assume that you have no particular problem with the fact that the majority of Chinese organs come from executed criminals (one must assume, with that one, that one has no problem with their execution, of course).

Do you get what I’m saying (I’m aware that I’m probably not being terribly cogent)?

Nick made the point, above, that there is a considerable difference between passive and active behaviour. If I do not donated my organs, then you may well die; but this is a far cry from the active taking of a life.

As an aside, I think that this problem will become irrelevant within a decade or so, anyway, through the growth of organs via host stem cells.

23. I’m never against referendums, I’d shout for many more than we experience if it were able to be done so cheaply, transparently and easily!

Perhaps I was hasty in so completely stating “public opinion”, feel free to imagine the word “probable” in front of it, for arguments sakes…just so that we don’t have anyone else against this policy falling over themselves to find another way to stall any real debate on the matter.

The article you link to is also very flaky. Out of the many plusses for the poor only one non-plus is given (having to sell part of his body to get a transplant rather than the current system of…just getting a transplant), the “improving our health” forgets that the NHS isn’t paying for organ transplants it’s paying for long term health care, and that the NHS buying organs for the poor would have massive knock on effects to the standard of care it can provide. In fact the only thing that stands up is the statement that we’ve already acknowledged, and that is that organs would become commodities and therefore that people with the money will be the ones to benefit from such a system.

I also can’t see where he ever said anything about borrowing against their own organs, something that I can never see as being healthy for reasons Sunny says, but also because business would be crazy to lend money to someone based on a living organ that can fail, grow diseased, and generally turn out to be useless for resale.

If you have another more competently written article on hand written with less holes in it I’d appreciate the heads up.

“Nick made the point, above, that there is a considerable difference between passive and active behaviour. If I do not donated my organs, then you may well die; but this is a far cry from the active taking of a life.”

If you are present during someone’s murder, while you did nothing to stop that person being murdered, you would probably be an accomplice. It is entirely ignorant for anyone to be even involved in this debate and claim that wilfully denying people of the opportunity to live is not the same as entering a lottery in effectively killing them (where you and many others “win” if no-one comes in with a donor card on time).

“On one hand, you have nine months of inconvenience followed by pain in childbirth, or you have a life prematurely snuffed out. Of course, there are other factors to complicate matters – such as the chances that the mother will die if the pregnancy is continued – but that is the essence of the argument.”

It is not the essence of the argument, and it is this simplicity which gives too much credibility to pro-life groups. There are social factors to consider far beyond the birth of the child, and if the child and mother are both to suffer a poor life because of something that the mother doesn’t want in the first place then who’s “Libertarian” values do you follow first? The right of the foetus to life or the right of the woman to hers? This is where libertarian ideology falls down hard and fast.

For what it is worth, it is implied state ownership that we libertarians are getting all excited about (and as you will know, we aren’t keen at the best of times).

If we want to increase organ donation (and we must remember that – for a multiplicity of complicated technical reasons – it is actually rather rare for a donor organ to be suitable for whichever recipient is hanging around), might I suggest that an organ donor card is treated like a legal will? That is, if you have a donor card, the family cannot stop your organs being used.

The right of the foetus to life or the right of the woman to hers? This is where libertarian ideology falls down hard and fast.

No, this is where one aspect of some libertarians’ beliefs might fall down (libertarianism is a very broad church). Those libertarians would reply, however, that the woman should have the baby and then give it up for adoption. They might also reply that she made the choice to have sex, etc.

As I said, there are considerable complications (especially the further down the decision chain that you go – what if the woman is raped); does mental health count as a factor, etc. I imagined that readers here were intelligent enough to imagine what those complications might be.

As I said, I am not one of those particular libertarians but, given that I have had very long discussions on this issue with people with whom I agree on every other subject, I was merely relaying their basic premise.

We cross posted. My complete scorn for anything you say was directed via 28 at 25.

And then you wrote 27, and I didn’t even realise which circle of hell you populated. Oh Joy of Joy’s. You are a clever Devil, and I hold garlic in my hand. Did not your allies, the Vampyres, offer a deal like that? Blood for eternal, what, limbo?

Solving the issue of families interfering in your wishes would help the problem, but not as much as not solving that problem and using presumed consent. Obviously using presumed consent and not letting relatives interfere is the best system for keeping people alive.

You say libertarianism is about life, liberty and property…and a deceased body has to come in this last category. Let’s assume everyone is a libertarian. You can stand there and say that you (a hypothetical you I’d like to point out!) don’t want to donate your organs for no other reason than they are yours and you’d like your body kept as it is. In doing so you deprive potentially 2 or 3 people the chance to live as well as multiples more for a better standard of living. In taking your action because of your belief that the state can’t impinge on your rights you have just impinged on the rights of maybe half a dozen people. How do you explain that away, or is Libertarianism truly that inward looking?

Libertarianism is, if you like, inward-looking in that it favours the right of the individual over the collective. Remember, libertarians are not saying that they would not freely donate their organs – indeed, most libertarians are non-religious and so have few qualms about dismemberment – but that they object to the state taking possession of those organs without consent.

In taking your action because of your belief that the state can’t impinge on your rights you have just impinged on the rights of maybe half a dozen people.

Is it a fundamental right to receive an organ donation? Let us, for a second, dispense with the cute innnocent kiddies and consider, for instance, George Best; he single-handedly ruined his liver through his alcoholism. Does he have a fundamental right to a new organ?

Is the delaying of death a fundamental right? I think that most libertarians would argue that it is not. Is the taking of life against fundamental rights? Yes.

At the most fundamental level, the idea of an opt-out or an opt-in is a question of voluntary or forced collectivism. Libertarians are against the latter, but very much for the former.

An Iraqi death toll denialist? The last time that I wrote anything about the Iraqi death toll was probably about the time that the Iraqi civilian casualties report, that everybody was so fond of quoting, was published in the Lancet.

What I pointed out – and I wasn’t the only one – was that the margin of error in the report was huge (it was over 90%) but most people only quoted the higher end death toll figure and did not mention the margin of error. IIRC, the Lancet published a qualification in the next issue.

This is a denialist about Iraqi death tolls, that can’t put a comment up on Crooked Timber. Similar reasons.

I last read Crooked Timber about three years ago, I would have thought. I don’t recall ever trying to comment there, nor ever being banned (I may have been for all I know but, since I don’t read it, I wouldn’t know). Are you sure that you aren’t confusing me with somebody else, Douglas?

As for being a climate change denialist – not really. By these definitions I would say that I am a sceptic, i.e. I look at the evidence. As it happens, the evidence that I have seen leads me to believe that anthropogenic climate change is a myth.

And I don’t think that my real name is terribly important, to be honest. But I believe that you can find it easily enough if you Google me: certainly the person who “outed” me just over a year ago had no problem. However, I post as “Devil’s Kitchen” or “DK” rather than under my own name, and I would prefer that you addressed me as that. It’s a courtesy, nothing more.

If you want to know what I do: I’m a 30 year old, freelance graphic designer, with a background in science. That’s all that’s really relevant.

Sunny – I think you are being mischevious!
It is a perfectly consistent libertarian position to believe that you should have autonomy with respect to your own body – and so oppose the “opt-out” approach to organ donation – while opposing abortion on the grounds that the foetus is an independent life and not simply a body part.

Just one more thought guys. We have good reason to believe that the Chinese state misuses, heinously, its powers over people and property, especially when it comes to organ re-distribution (bearing in mind that the criminals it executes may have done nothing other than subscribe to a banned religion) . It doesn’t stop there being plenty of doctors and state employees willing to engage in the abusive system.

Do you think it is because Chinese people are innately less moral and respectful of human rights than other people? Or do you think it is more likely they are normal people put into a certain cultural and institutional framework (and incentives) that encourage normal people to do terrible things? No one would deny that the vast majority of doctors in this country are trustworthy (having said that there are one or two surgeons who refuse to take part even in this country, due to the moral knife edge of removing organs from even an officially dead body that must still have blood pumped around it to keep those organs viable). But why do we trust doctors and state officials so much? Isn’t it because they have worked for so long and continue to work in a legal and cultural framework that gives so much respect to the rights of the individual?

How confident can you be that the trust will remain in the longterm, if the underlying framework is eroded by even subtle changes in the law like this?

To get back to the point, surely ian got it right at 12. If you don’t want to donate your organs – or those of your children – then fine, but you shouldn’t be able to benefit from anyone else’s.

This idea that you should only donate voluntarily seems bizarre: if it’s a good idea to save someone else’s life at no cost to you (which seems pretty obvious to me) and the most effective way to do that is to make organ donation something you opt out of rather than into (simply because of the numbers), then I think that trumps whether you get a nice warm feeling about having the choice.

I think the bigger problem with the “state as bodysnatcher” argument is this: For a significant number of people it is agents of the state (i.e NHS doctors) who will decide when/if they die. These same people are will also be charged with the responsibilty for collecting organs. This creates a potential conflict of interests. Will there be financial pressures/rewards for organ harvesting and will that influence clinical decisions ? Could there be a scenario when the market price of grannies organs outweighs the cost of her care, and could doctors and/or families in effect profit from a relatives death ?

I take it that those commenters convinced that doctors are untrustworthy state employees just waiting to harvest their organs will ask the ambulance men to drive them to the nearest aromatherapist should they find themselves suffering severe chest pains one day?

Alas not all doctors behave properly – see Alder Hey.
A perfect example of “good” motives provoking unethical behaviour.
It is a sensible prinicple, especially in respect of anything to do with ceding more power to the state, to avoid the risk of conflicts of interest.

“most libertarians are non-religious and so have few qualms about dismemberment – but that they object to the state taking possession of those organs without consent.”

My view first diverges here. Presumed consent doesn’t mean without consent. If people have the ability to withdraw their already presumed consent then it is, in effect, giving consent if you don’t take the action to remedy things in line with your beliefs. This is perhaps why I’m getting so confused, because it’s not like the state is saying we’ll take your kidneys when you’re dead, like it or not, they’re saying we’d like to take your kidney’s when you’re dead and are going to assume that (as polls suggest) you are pro-organ donation and only request you tell us if this is not the case. Perhaps a counter view is that a libertarian who is pro-organ donation should object to the state throwing away their organs without their consent?

“Is it a fundamental right to receive an organ donation? Let us, for a second, dispense with the cute innnocent kiddies and consider, for instance, George Best; he single-handedly ruined his liver through his alcoholism. Does he have a fundamental right to a new organ?”

This depends on the situation really doesn’t it. There has to be a level of assessment on why people are where they are in the queue, it can’t be first come first serve it has to be most needy with best prospects of surviving come first serve. I don’t know in all honesty how the system works intricately but if this isn’t how it is done then that is a separate issue from organ donation. I think everyone has a fundamental right to a chance at continuing life if the resources are there. Would you say that George Best should not have got a new Liver if by doing so no-one else were disadvantaged and there were organs to spare? Hypothetically of course.

“Is the delaying of death a fundamental right? I think that most libertarians would argue that it is not. Is the taking of life against fundamental rights? Yes.”

I think you’re splitting hairs here, and is really just a repackaging of the same disturbing view that you seem to be stating Libertarians have, and that is if they aren’t directly doing the killing they don’t feel remorse for the lives that they could be saving and the lives that could well go on for decades longer with the aid of a new organ.

“Am I explaining myself?”

You are, very well as far as I’m concerned, but I just really don’t buy it as anything more than some weird bastardisation of NIMBYism where you’re happy to do something or be a part of something unless you’re forced to stare it in the face. I’m afraid I can’t ever take someone’s views seriously when they say they’re for a particular idea or action but would be against ways of making it happen more because of principles. Maybe this is where we agree to disagree.

45. “How confident can you be that the trust will remain in the longterm, if the underlying framework is eroded by even subtle changes in the law like this?”

You’re putting far too much stock in what these changes will do to doctors. If anything I would argue that it *eases* pressure on doctors to get organs. Right now there is a severe shortage and waiting lists are huge. NOW is the opportune time to act in bad faith and get organs quicker. If there are more organs coming naturally through the system there is a LESSER emphasis on the need to get the organs that could be available now quicker.

Same goes for 47, with proper procedures in place a doctor should never be able to personally profit from a system with no free market in place, nor should the families, the idea of money in return for the death of someone could work in some ways but ultimately offers up too much of a motive to move natural courses along artificially. But all in all the situation is ripe *now* for malpractice, not when there are more organs available.

48. Anecdotal evidence is not indicative of the vast majority of practitioners in this country now is it, or should we be saying Shipman goes to show Doctors are generally schizophrenic mass murderers?

I suspect that we will not ever agree, but look at it this way: by-passing any issues of the state, if someone has a right to have an organ transplant then they effectively own a part of some other person’s body.

This is incompatible with libertarian ideals of self-ownership.

But, yes, we are at a point of fundamental disagreement: for you, the end justifies the means. For me, it doesn’t.

“if someone has a right to have an organ transplant then they effectively own a part of some other person’s body.”

An interesting view on the situation that I must once again disagree with (surprise, surprise :P). The right to a transplant is the right to receive something if it is there. We are not talking here about someone being guaranteed anything but the opportunity if it arises, there is no act here for predetermination for the destination of your insides.

I’d like to finish my contribution here since the dead end is ahead, by grounding this again in reality. A look at the transplant website shows that for each donor two transplants are able to take place, though if you take out living donors even more “use” is taken from a dead persons generosity. This has saved almost 1000 lives yet over 7000 people still wait on the transplant list. Critically, if these 1000 donors represent roughly the 25% of the population on the donor list, then an opt-out system that turned 90% of the population in to donors would provide somewhere in the region of 3500 donors which would compare pretty much to a similar amount of lives saved. This would still only be half of the yearly waiting lists cleared. Anything more complicated than the opt-out system is only going to mean that more people on that waiting list will be let down, and we’re already telling half of them they’ll have to wait over a year as it is, if they survive at all.

Exactly Tim. It took me about three seconds to make a little list of ways you have a relationship with the state after you’ve died:

“There is both a criminal penalty (I assume) and a massive social sanction to necrophilia.
People frequently refight criminal trials after the person convicted has died in order to establish their innocence.
A will has legal force.
Even under Brown’s proposed reforms we will legally respect explicit opt-outs.”

Well, that’s not really what I said, it’d be comparable maybe if you wanted Al Gore to shut up but instead told everyone you wanted to listen to him because there was talk of banning his film. I wouldn’t be able to take that seriously. It’s a double standard in terms of what you actively do solely because of the way that choice is presented to you.

No one is saying “don’t get a donor card, they might make donating opt-out”. They’re saying “even though I do think organ donation is a good thing I don’t want it forced on anyone”. My analogy is far better.

Well, whatever you wish to believe on that front, I’m not going to argue since your analogies different subject matter (desires vs actions) make it amazingly easy for you to misinterpret what is put down to try and satisfy whatever it is you’re trying to say. The fact remains that wanting to do something that saves lives then reversing that decision if the system changes against purely ideological principles is spiteful and unjustifiable, and certainly would make anyone question your real motives for donating in the first place. At least DK had the decency to explain that while he would opt-out he would also opt back in on his own terms, showing in his case at least that the act of donation is the most important thing.

Who is reversing a decision? People are opposing the idea that organ donations be made opt out. They’re mostly passing no comment on how this will affect their own decision of whether or not to be opted in or not. You seem to have constructed a complete straw man.

I’m not tarring people with the same brush here so please don’t make arguments as such to serve your own ends. My point as it originally stood is that I can’t understand the people, however few or many that is, that are choosing to do what I’ve described. Nothing more and nothing less.

As an aside, after reading the Human Tissues Act of 2004 it is clear we already live under some level of presumed consent, with strings attached. Given the current system’s ambiguity over what will happen to your body but without you perhaps realising it, wouldn’t the anti-presumed consent lobby prefer to at least know in black and white what will happen to them after they die rather than the current “maybe/maybe not, you’ll never know” system?